Safety and Family Satisfaction of a Home-Delivered Chemotherapy Program for Children with Cancer

Abstract

Background. Home chemotherapy programs for children with cancer are safe and feasible but have hardly worked in Italy, and there is conflicting evidence on their impact on the quality of life. In Friuli Venezia Giulia, Italy, a home chemotherapy program was implemented between 2011 and 2019. This study investigates safety, feasibility and satisfaction of parents. Methods. Patients between 0 and 18 years diagnosed with malignancy were included. Deceased patients and patients whose families moved abroad or interrupted contact with the service were excluded. Adverse effects comprised immediate deterioration of the patient’s condition, equipment failure, errors in drug storage, dose or patient identification and personnel safety issues. Parental satisfaction was explored through an email survey of 32 Likert-type and short open questions. Results. Thirty-five patients received 419 doses of intravenous chemotherapy at home (cytarabine, vincristine, vinblastine). No adverse events were reported. Twenty-three families out of 25 eligible completed the survey. Most reported being “very satisfied” with the possibility of maintaining a work/domestic routine and reducing time and financial burden of hospital access. Most were “very satisfied” with the opportunity for their child of being less troubled by the treatment. Besides, most reported being “very satisfied” with the chance for healthy siblings of maintaining their routine and coping with their brother/sister’s disease. Most perceived the program as safe. All families recommended extending the program to all children in the region. Conclusions. This study supports home chemotherapy as safe and effective, positively influencing the quality of life for children and families.